Published data indicates that the number of United States graduates entering family practice residency programs dropped by 50% between 1997 and 2005 (Bodenheimer, 2006). There is additional concern about where many of the primary care physicians are practicing. In Oklahoma, primary care physicians are concentrated around the Tulsa and Oklahoma City metropolitan areas; however, most Oklahoma counties are designated as Health Professional Shortage Areas and reflect few primary care physicians working in those counties. The RMT will address these barriers by developing and implementing an integrated curriculum to train rural, primary care physicians, with clinical rotations taking place predominantly in rural settings. There is strong evidence that training location and permanent practice location are highly correlated, which indicates that students who complete the majority of their clinical training in rural areas will remain there after graduation (Henry, Edwards, & Crotty, 2009).
The RMT curriculum structure is intended to mirror the approach to broader curriculum revision taking place at the OSU College of Osteopathic Medicine (COM) by maximizing clinical and biomedical science correlation and coordination and putting instruction about normal structure and function, pathology, and clinical medicine in the same course. Each course will focus on a different physiological system. The proposed structure will also include provisions for teaching topics and skills prerequisite or introductory to subsequent clinical and systems courses, as well as topics and skills that do not fit easily into a “systems” approach.
OSU COM currently plans to offer the RMT program to up to 24 students per year. The College will use the remainder of the 2011 – 2012 academic year to complete planning activities, such as developing specific course content, training modules, patient simulation experiences, and case studies. In the 2012 – 2013 academic year, OSU COM will begin implementing this curriculum for students beginning clinical rotations as third year medical students.
A few months ago, second year medical students at OSU COM were offered an opportunity to select participation in the RMT beginning in their third year. The first cohort of thirteen RMT students will begin clinical training in July 2012. These students are an eclectic mix, including nine women and four men. Most of the students grew up in rural areas ranging from Duke in extreme southwestern Oklahoma to Pryor in the northeastern part of the state. The remaining students were raised in urban areas near Tulsa or Oklahoma City but are committed to practicing medicine in rural areas. Existing and recently expanded rural primary care residencies in the state will allow students to continue their post-graduate training in rural areas resulting in a higher probability that these physicians will maintain their commitment to rural practice.
Developing and implementing the RMT will have a five-year project cost of $950,000, which will be funded entirely through a federal grant from the Health Resources and Services Administration at the United States Department of Health and Human Services.